Jarosław Królczyk1, Karolina Piotrowicz1, Jerzy Chudek2, Monika Puzianowska-Kuźnicka3,4, Małgorzata Mossakowska5, Aleksandra Szybalska5, Tomasz Grodzicki1, Anna Skalska6, Jerzy Gąsowski1. 1. The Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Ul. Śniadeckich 10, 31-531, Kraków, Poland. 2. Department of Internal Medicine and Oncological Chemotherapy, School of Medicine in Katowice, Medical University of Silesia in Katowice, Katowice, Poland. 3. Department of Human Epigenetics, Mossakowski Medical Research Centre, PAS, Warsaw, Poland. 4. Department of Geriatrics and Gerontology, Centre of Postgraduate Medical Education, Warsaw, Poland. 5. International Institute of Molecular and Cell Biology in Warsaw, Warsaw, Poland. 6. The Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Ul. Śniadeckich 10, 31-531, Kraków, Poland. anskal@su.krakow.pl.
Abstract
BACKGROUND: Prevalence of peripheral arterial disease increases with age and is related to increased morbidity and mortality. The clinical diagnosis includes the measurement of ankle-brachial index (ABI). AIMS: To check the prevalence of abnormal ABI, and the value of physical examination of arterial system in detection of ABI < 0.9. METHODS: We performed subgroup analysis of patients included in the PolSenior survey. We measured ABI, performed physical examination of arterial system, assessed laboratory and questionnaire factors related to atherosclerosis. Participants were divided according to ABI strata of < 0.9, 0.9-1.4 and > 1.4. Clinical score of abnormalities on physical examination was proposed. Using logistic regression, we obtained areas under the curve (AUC). RESULTS: The mean age of 844 participants (53.3% men) was 74.7 (10.6) years. ABI < 0.9 was found in 20.3% participants and it was linked to history of myocardial infarction, hypertension and renal failure. In the entire group, 72.4% of subjects declared, that they were able to walk a distance of 200 m without interruption. Higher clinical score was associated with lower ABI. Full physical examination (AUC = 0.67) followed by examination of lower extremities (AUC = 0.65) showed strongest diagnostic value for PAD based on ABI. Neither ABI nor clinical examination was a good predictor of the inability to walk 200 meters without difficulties. DISCUSSION/ CONCLUSIONS: Full clinical examination, only moderately, adds to detection of PAD. The ability to walk 200 m is not a good measure of PAD in older subjects.
BACKGROUND: Prevalence of peripheral arterial disease increases with age and is related to increased morbidity and mortality. The clinical diagnosis includes the measurement of ankle-brachial index (ABI). AIMS: To check the prevalence of abnormal ABI, and the value of physical examination of arterial system in detection of ABI < 0.9. METHODS: We performed subgroup analysis of patients included in the PolSenior survey. We measured ABI, performed physical examination of arterial system, assessed laboratory and questionnaire factors related to atherosclerosis. Participants were divided according to ABI strata of < 0.9, 0.9-1.4 and > 1.4. Clinical score of abnormalities on physical examination was proposed. Using logistic regression, we obtained areas under the curve (AUC). RESULTS: The mean age of 844 participants (53.3% men) was 74.7 (10.6) years. ABI < 0.9 was found in 20.3% participants and it was linked to history of myocardial infarction, hypertension and renal failure. In the entire group, 72.4% of subjects declared, that they were able to walk a distance of 200 m without interruption. Higher clinical score was associated with lower ABI. Full physical examination (AUC = 0.67) followed by examination of lower extremities (AUC = 0.65) showed strongest diagnostic value for PAD based on ABI. Neither ABI nor clinical examination was a good predictor of the inability to walk 200 meters without difficulties. DISCUSSION/ CONCLUSIONS: Full clinical examination, only moderately, adds to detection of PAD. The ability to walk 200 m is not a good measure of PAD in older subjects.
Authors: María Teresa Alzamora; Rosa Forés; José Miguel Baena-Díez; Guillem Pera; Pere Toran; Marta Sorribes; Marisa Vicheto; María Dolores Reina; Amparo Sancho; Carlos Albaladejo; Judith Llussà Journal: BMC Public Health Date: 2010-01-27 Impact factor: 3.295